This guide is based off an extensive literature review to assist policymakers and practitioners in assessing the utility of mental health courts. It provides an overview of how mental health courts function and explores research findings that address the extent to which mental health courts have been found to achieve their stated goal.

This is a witness testimony as presented by the ACLU for the US Congress Subcommittee on Human Rights and the Law that explores issues surrounding inmates, including women, juveniles, and immigration detainees, with mental illnesses. The testimony also details the successful reforms of institutions that have produced better outcomes in terms of mental health, prison discipline, and the ability to integrate back into society upon release. The ACLU closes by urging Congress to fund reforms on the federal level to create incentives for states to adopt similar initiatives.

A retrospective review of mental health court records to examine the phenomenology and outcomes of 224 defendants with and without co-occuring intellectual disabilities (IDs). This study examined the prevalence of defendants with IDs in the court and compares defendants with dual diagnoses with defendants with only mental health disorders. This study found that approximately 11% of defendants in the mental health court also had IDs. Compared with individuals with only mental health disorders, those with dual diagnoses were more likely to be younger, male, African-American and less well-educated, and also were more likely to show externalizing behavior symptoms.

This study explored the use of sanctions, specifically jail sanctions, and incentives among 447 mental health court participants across the United States. Results show that jail sanctions are used in most mental health courts, and other sanctions are similarly used across most all mental health courts. Participants charged with “person crimes” are the least likely to receive any sanctions, including jail, whereas those charged with drug offenses are most often sanctioned. The factors associated with receiving a jail sanction are recent drug use, substance use diagnosis, and drug arrests; being viewed as less compliant with court conditions, receiving more bench warrants, and having more in-custody hearings; and mental health court program termination. Important to note, this study did not find any personal characteristics related to receiving the various sanctions.

Council of State Governments Justice Center. (2009). Mental health courts: A primer for policymakers and practitioners. Bureau of Justice Assistance, Office of Justice Programs, US Department of Justice. Retrieved from http://consensusproject.org/mhcp/mhc-primer.pdf

This primer acts as a Frequently Asked Questions about mental health courts, including what it is, types of participants, structure, function, goals, and applicability to juveniles, current research, considerations, and resources.

Hodges, J. Q., & Anderson, K. M. (2005). What do social workers need to know about mental health courts?. Social Work in Mental Health, 4(2), 17-30.

This article explored the impact and role that social workers have on the mental health courts, by explaining the background, context, and specific features and how that relates to what social works need to know in order to work effectively in mental health courts.

This is the first article to date to critically examine this new form of specialty court from the lens of the mental health system. This article describes and examines mental health courts against a comprehensive set of criteria that define an ideal mental health intervention, including theoretical, empirical, values-based, and pragmatic considerations. The discussion begins with the framework for identifying evidence-based practices in mental health and continues with an examination of the current evidence related to each of nine criteria of an ideal mental health intervention. In many aspects, mental health courts appear to offer a promising addition to mental health and criminal justice systems; however, the fast growth of mental health courts across the nation may have outpaced their theoretical and empirical support.

This study from the US Federal Government explored the prevalence of mental health problems among prisoners in federal and state prisons and local jails, and found that more than half of all prison and jail inmates were found to have a mental health problem.

This study explored the personal experiences and perceptions of mental health court participants. Defendant perceptions are distinct from observer perceptions, which tended to be more sensitive to the differences in judges. Also, procedural justice was negatively correlated with symptoms at baseline and was positively correlated with participant’s attitudes toward their own recovery.

This study explored the challenges faced by a multijurisdictional, suburban Mental Health Court, primary ones included not being able to advance from hearing municipal cases only to state misdemeanor and felonies, not having the resources to expand program capacity for municipal cases, and participants not being able to always access needed mental health treatment, rehabilitation, and support services.

Luskin, M. (2012). More of the same? Treatment in mental health courts. Law And Human Behavior, doi:10.1037/lhb0000016.

This study describes the context, amount, and types of treatment for 82 mental health court participants and a matched sample of 89 defendants who underwent regular criminal court processing. The study compared treatment from the period 6 months prior to entry into the mental health court or arrest to that at a 6-month follow-up. This study found that mental health court participation increased the frequency of outpatient treatment, but that social services and treatment specialized to address criminal risk factors were uncommon throughout the longitudinal study. Although most received some form of treatment, the mental health court sample reported more frequent and more varied interventions.

This manual overviews a set of 14 performance measures that offers court managers and administrators a tool to monitor the performance of mental health courts based on the guidance from national experts. The measures are designed to be used as a management tool, to monitor program performance, and to demonstrate accountability to funding agencies, court leaders, external partners, and the public.

This retrospective observational study evaluated whether a mental health court can reduce the risk of recidivism and violence by people with mental disorders who have been arrested by comparing the occurrence of new criminal charges for 170 people who entered a mental health court after arrest and 8,067 other adults with mental disorders who were booked into an urban county jail after arrest during the same interval. The results showed that participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes. Successful completion of the mental health court program was associated with maintenance of reductions in recidivism and violence after graduates were no longer under supervision of the mental health court.

This study examines the effect of one mental health court on criminal justice outcomes by examining arrests and offense severity from one year before to one year after entry into the court, and by comparing mental health court participants to comparable traditional criminal court defendants on these measures. Results show that mental health courts reduce the number of new arrests and the severity of such re-arrests among mentally ill offenders, as well as showed that those who graduated from the program had few re-arrests then those that dropped out prior to graduation.

This study explores the fiscal impact of a mental health court program by providing practical, nonpartisan advice and consensus-driven strategies, informed by available evidence, to increase public safety and strengthen communities through the use of mental health court dockets.

Thompson, M., Osher, F., & Tomasini-Joshi, D. (2007). Improving responses to people with mental illnesses: The essential elements of a mental health court. Council of State Governments Justice Center for Bureau of Justice Assistance, Office of Justice Programs, US Department of Justice. https://www.bja.gov/Publications/MHC_Essential_Elements.pdf